Antineoplastics - concepts

Question 1

What is cancer?

Answer 1

A disease of altered cell growth, cell division, and cell differentiation.

A mass of tissue, the proliferation of which is not controlled by normal physiological processes

Question 2

What happens to growth factors in cancer cells?

Answer 2

Increased - there is increased intracellular signals to cells to divide

Question 3

What happens to cyclin-dependent kinases in cancer cells?

Answer 3

Increased - they also tell cells to divide

Question 4

What happens to gene expression in cancer cells?

Answer 4

It’s altered in some way

p53 gene is DECREASED - this allows mistakes in DNA replication to not be caught (normally this would cause apoptosis) and the cell continues to divide even with the mistakes in DNA

Question 5

What happens to contact inhibition in cancer cells?

Answer 5

Decreased

Cells normally stop dividing once they come in contact with other cells, but not in cancer - they keep dividing

Question 6

What’s the most common type of cancer in men?

Answer 6

Prostate

Question 7

What’s the most common type of cancer in women?

Answer 7

Breast

Question 8

What’s the most common type of cancer in children ages 0-14?

Answer 8

Acute lymphocytic leukemia then brain/CNS

Question 9

What’s the most common type of cancer in adolescents ages 15-19?

Answer 9

Hodgkin lymphoma then thyroid carcinoma, then brain/CNS

Question 10

What is the deadliest cancer in men?

Answer 10

Lung, then prostate

Question 11

What’s the deadliest cancer in women?

Answer 11

Lung, then breast

Question 12

What is hyperplasia?

Answer 12

Increase in size or number of cells
Function is unchanged
It is reversible

Question 13

What is metaplasia?

Answer 13

Adaptive substitution of one differentiated cell type for another differentiated cell type (ie callouses with chronic irritation)

Protective response

Some loss of function

Question 14

What is dysplasia?

Answer 14

Loss of uniformity
Loss of architectural orientation
Still reersible

Question 15

What is neoplasia?

Answer 15

Uncoordinated growth
Decreased response to suppressor genes (p53, cyclin-dependent kinases)
Immortalization
Irreversible

Question 16

Describe benign tumor cells

Answer 16

Localized
Enclosed in a fibrous capsule
Surgically removable
Patient usually survives

Question 17

Describe malignant tumor cells

Answer 17

Spreads to and destroys adjacent tissue
No capsule
Can metastasize
Can result in death of patient

Question 18

Describe grade 1 tumors

Answer 18

Closely resembles tissue of origin; retains specialized function

Question 19

Describe grade 2 tumors

Answer 19

Moderately differentiated, less like tissue of origin, increased mitotis

Question 20

Describe grade 3 tumors

Answer 20

Poorly differentiated, tumor doesn’t resemble tissue of origin, increased variation, increased mitosis

Question 21

Describe grade 4 tumors

Answer 21

Very poorly differentiated, no resemblance to tissue of origin, highly variable, enhanced mitosis, metastatic

Question 22

True or false: Single “clone-ogenic” tumor stem cell has potential for unlimited replication

Answer 22

TRUE

So you must kill EVERY tumor stem cell

Question 23

True or false: Different tumors have the same growth patterns, which are the same during the same stage of disease

Answer 23

False

Different tumors have different growth patterns which can change based on stage of disease

Question 24

Which type of cancer is well differentiated? Which is non-differentiated?

Answer 24

Early lung cancers

Lung cancers

Question 25

What type of cancer is slow? What type of cancer is fast?

Answer 25

Colon, prostate are slow Leukemia is fast

Question 26

What is gompertzian growth?

Answer 26

99.9% of tumor cells are killed each round of chemo, you lose 3 log units every time In between the rounds of chemo the tumor continues growing but you just kill it off again

Question 27

Treatment should involve what as the first step?

Answer 27

Removal of the tumor Surgery Radiation Chemotherapy

Question 28

When can tumors be surgically removed?

Answer 28

Well-localized and well-differentiated

Question 29

When can tumors be removed by radiation?

Answer 29

Localized tumors that aren't easily removed

Question 30

When can tumors be removed by chemotherapy?

Answer 30

Targets all rapidly dividing cells | Systemic effects increases chances against metastatic cells

Question 31

At what amount of cells do you usually see diagnosis?

Answer 31

10^9

Question 32

At what amount of cells do you usually see symptoms?

Answer 32

10^10.5

Question 33

At what amount of cells do you usually see death?

Answer 33

Over 10^12

Question 34

What drug classes are cell cycle non-specific?

Answer 34

Alkylatic drugs | Intercalating drugs

Question 35

What drugs act in the S phase?

Answer 35

DNA synthesis inhibitors

Question 36

What drugs act in the transition from S to G2 phase?

Answer 36

Bleomycin | Etoposide

Question 37

What drugs act at the M phase?

Answer 37

Mitotic inhibitors

Question 38

What drugs act in the G1 phase?

Answer 38

None specifically act at the G1 phase

Question 39

Benefits of combination therapy?

Answer 39

Minimizes resistance | Minimizes toxic effects

Question 40

What types of adjuvant therapies are used?

Answer 40

Antiemetic drugs | Stimulate bone marrow growth

Question 41

Why do you see alopecia with cancer treatments?

Answer 41

BC drugs target rapidly growing cells and kill them, hair cells are constantly growing so to kill them means to lose hair

Question 42

What side effects are seen in all cancer treatments that target rapidly dividing cells?

Answer 42

Bone marrow suppression (myelo and immune suppression) GI tract ulcers (mouth sores) Alopecia (hair loss) Decreased sperm count and menstrual irregularities